协和听课笔记----药理学

协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学
协和听课笔记----药理学

协和听课笔记----药理学

Brand: 中国协和医科大学出版社    Sold By: EM China
$45.17 In Stock
Item can be returned in its original condition for a full refund or replacement within 30 days of receipt.
Ships from China, Arrives in 7-14 business days
Delivery:
28
October2024
-
06
November2024
Delivery guarantee
$5 Credit If Delayed
Full Refund If Item Is Damaged
15-Day Full Refund If No Updates
30-Day Full Refund If Not Delivered

100% Satisfaction Guarantee

Amazing Value

Fast Shipping

Expert Customer Service

协和听课笔记----药理学

协和听课笔记----药理学

$45.17

产品特色

内容简介
Product Details
产品特色

内容简介

北京协和医学院是中国*早的一所八年制医科大学，在近100多年的办学过程中总结了相当多的教学经验，在很多的科目上有着独特的教学方式。本套丛书是以协和老师上课笔记的整理为基础，根据第九版教材进行精心编写，实用性极强。本套丛书的特点如下：①结合课堂教学，重难点突出。总结核心问题，突出重难点，使读者能够快速抓住内容；精析主治语录，提示考点，减轻读者负担；精选历年真题，力求简单明了，使读者易于理解。②紧贴临床，实用为主。医学的学习，尤其是桥梁学科的学习，主要目的在于为临床工作打下牢固的基础，无论是在病情的诊断、解释上，还是在治疗方法和药物的选择上，都离不开对人体*基本的认识。桥梁学科学好了，在临床才能融会贯通，举一反三。学有所用，学以致用，贴近临床，实用为主。③图表形式，加强记忆。通过图表的对比归类，不但可以加强加快相关知识点的记忆，通过联想来降低记忆的“损失率”，也可以通过表格中的对比来区分相近知识点，避免混淆，帮助大家理清思路，在*程度上帮助我们理解和记忆。

作者简介

主编陈玮，北京协和医学院八年制博士毕业，现就职于中日友好医院。参编人员均为北京协和医学院八年制博士毕业生，现就职于国内各大医学院校或医院。参编多部学术专著的编写工作，发表SCI及在国内核心期刊发表多篇论文。

目　　录
章 支气管扩张核心问题1．支气管扩张的诊断、治疗原则和方法。2．支气管扩张的病因及发病机制和鉴别诊断。内容精要支气管树的异常扩张，多继发于呼吸道感染（麻疹、百日咳后的支气管肺炎）和支气管阻塞，由于支气管及其周围肺组织的炎症破坏支气管壁引起支气管管腔变形、持久扩张。主要表现为慢性咳嗽、咳痰、咯血。一、病因①主要由于支气管-肺反复感染、支气管阻塞；感染导致粘膜水肿、分泌过多而阻塞，阻塞后引流不畅又加重感染。②百日咳、麻疹后的支气管肺炎是常见的原因，多见于左肺下叶；结核纤维组织增生和收缩牵拉，多发于上叶尖后段和下叶背段；ABPA损伤支气管壁；支气管内外肿物、瘢痕狭窄等都能导致远端引流不畅而扩张。③部分患者为特发性支扩。主治语录：病因的遗传因素中有个卡特金纳综合征，有时需要引起重视。二、病理生理支扩部位血流正常、通气减少，造成功能性分流，引起低氧血症；病变广泛破坏肺毛细血管时，由于缺氧导致肺小动脉收缩，肺循环阻力增加，可造成肺动脉高压；三、临床表现1．症状多发于儿童或青年，可有百日咳、麻疹后肺炎或支气管肺炎迁延不愈的病史；以后常有反复的下呼吸道感染。慢性咳嗽、咳痰（变动体位时明显、急性感染时痰多数百毫升、静置可以分泡沫层、黏液层、脓性层、坏死沉淀物，厌氧菌感染有臭味）、反复咯血（有的患者只有咯血，干性支扩）。2．体征下肺和背部比较固定的粗湿罗音、常有杵状指。四、辅助检查①CXR--粗乱的肺纹理中有蜂窝状透亮阴影、沿支气管的卷发状阴影，感染时阴影内出现液平。②CT--HRCT可确诊，管壁增厚的柱状扩张、成串成簇的囊性改变。五、鉴别诊断①慢性支气管炎-中老年吸烟者多见，慢性咳嗽、咳痰（脓痰少，多为黏痰），冬春季节多见。②肺脓肿-高热、咳嗽、大量脓臭痰、CXR可见空洞和液平。③肺结核-结核中毒症状，PPD、痰检、CXR可以鉴别。④先天性肺囊肿-继发感染时可发生咳嗽、咳痰、咯血，X线可见多个边界纤细的圆形或椭圆形阴影，周围无浸润，HRCT可明确诊断。六、治疗1．急性期治疗急性感染时抗生素治疗。2．保持呼吸道引流通畅①体位引流，每次15～30min，每天2～3次，间断深呼吸并用力咳嗽、拍背可以提高效果可先用雾化吸入、祛痰剂稀释痰液。②纤维支气管镜吸痰。③支气管扩张药（不咯血时）利于痰的排出。主治语录：祛痰时注意病人的相应体位，以便顺利祛痰。3．咯血的治疗①咯血时患侧卧位，妊娠和高血压不能使用垂体后叶素（提高血压、促进宫缩）。 ②咯血危及生命、反复咯血病变不超过2叶时可手术切除。4．手术治疗 手术是根治的方法，病变局限于一叶或一侧肺，反复咯血或感染者可手术。历年真题（执）1．双侧支气管扩张反复大咯血，A．抗生素B．支气管动脉栓塞C．切除病变肺叶D．口服钙通道阻滞剂E．支气管镜下介入治疗（研）2．男，43岁。反复咳嗽、咳脓痰10年，加重5天入院。吸烟史15年，已戒10年。查体：右下肺可闻及较多湿啰音及少量哮鸣音。可见杵状指。胸部X线片示右下肺纹理增粗、紊乱。该患者应首先考虑的诊断是A．支气管结核B．支气管肺癌C．慢性阻塞性肺疾病D．支气管扩张E．支气管哮喘参考答案：1．B 2．D第二章 原发性肝癌核心问题1．本病的临床表现和诊断治疗要点。2．本病须与哪些疾病作鉴别。内容精要自肝细胞或肝内胆管细胞发生的癌，表现为纳差、消瘦、乏力、肝硬化表现、肝痛、肝脏肿大。一、发病机制①乙型和丙型肝炎、酒精导致肝硬化常可导致肝癌发生。②血吸虫、淤血、胆汁淤积导致的肝硬化与肝癌无关。③黄曲霉毒素污染的或含有亚硝胺类物质的粮油、食品。二、病理特征1．大体分类①块状型-直径 5cm， 10cm的为巨块；易发生坏死导致肝脏破裂；主治语录：边缘可有小卫星灶。②结节型-直径 5cm；③弥漫型-米粒到黄豆大小的结节弥漫分布全肝，多死于肝功能衰竭；④小肝癌-单个结节直径 3cm或相邻2个结节直径之和 3cm。2．细胞分型①肝细胞肝癌占90%；②胆管细胞癌 10%；③混合型或过渡型。3．转移途径（1）血行转移①首先侵犯门静脉形成癌栓，导致腹水并在肝内形成多发转移；②下一站转移到肺；③肿瘤血供主要来自肝动脉。（2）淋巴转移-多见肝门淋巴结。（3）种植转移-癌细胞脱落种植到腹膜、胸膜（形成腹水、腹水）。三、临床表现早期可无任何症状为亚临床型肝癌，晚期可有肝硬化、肝大、肝区疼痛、黄疸的表现。1．全身表现发热、消瘦、纳差、乏力、营养不良。肝是维持糖代谢的重要器官-肝病时会发生自发性低血糖。主治语录：注意与内分泌瘤鉴别。2．肝硬化表现肝功能减退、脾大、腹水、侧支循环；血性腹水较特异。可能由于肝癌本身伴有肝硬化，也可由于癌栓堵塞门静脉主干。3．肝区疼痛持续性钝痛-肝癌增长导致包膜牵拉，侵犯右膈时右肩牵涉痛。癌结节破裂-血液和坏死组织进入腹腔，突然剧痛，遍及全腹，可引起休克。4．肝大质地坚硬、凹凸不平、压痛、血管杂音特异（动静脉瘘）。四、并发症（1）肝硬化的并发症①肝性脑病②感染③上消化道出血④肝肾综合征；（2）癌结节破裂①局限在包膜下可产生压痛性肿块②包膜破裂发生急性腹痛和腹膜刺激征、出血、休克③补液、输血、止痛、紧急肝动脉栓塞；五、辅助检查1．血液检查（1）AFP升高①除外妊娠和卵巢生殖细胞肿瘤（内胚窦瘤）的基础上对肝癌诊断有意义②也可见于肝炎、肝硬化、转移癌（升高幅度不高，与ALT平行）③ 500ugL持续4w、 200ugL持续8w、浓度逐渐升高不降④可早于症状8～11月；主治语录：AFP升高但 200ugL，与ALT同步变化提示慢性活动性肝炎、肝硬化2．影像学检查（1）CXR-右膈高位提示肝癌。（2）BUS-可发现直径 2cm的肿瘤，BUS AFP=普查。（3）CT-局灶性边界清晰的密度减低区，可发现直径 2cm的肿瘤，同时进行肝动脉造影CTA可发现 1cm的肿瘤，增强时造影剂快进快出。（4）DSA血管造影①选择性腹腔动脉和肝动脉造影可发现 1cm的肿瘤。②CT、Bus不行才选用，发现小肝癌的。（5）放射性核素-99mTc-HIDA、99mTc-PMT可以被肝细胞摄取然后分泌进入胆道系统，肿瘤细胞摄取后不能分泌进入胆汁，所以可以使肿瘤显像，多排除血管瘤。（6）肝穿-可以确诊。六、诊断对肝炎史 5年或乙丙肝阳性，年龄 35岁患者；每年1～2次BUS AFP。七、鉴别诊断①非癌性占位-肝脓肿（肝大无结节、触痛明显、右上腹肌紧张、血象高、BUS可见液性暗区）、血管瘤、包虫（可通过CT诊断）。②转移癌-AFP阴性，关键是找出原发灶和病理检查。③活动性肝炎-ALP和AFP往往同时升高，其他肝癌标记物阴性。④肝硬化。八、治疗1．手术切除①一般状况好无心肺肾功能损害、肝功能I级（无明显腹水、黄疸、远处转移）、病变位于一叶或半肝、未侵犯肝门和门静脉。②不能手术的肝癌综合治疗后缩小或术后复发较局限者也可手术。③肝功能正常者手术切除不超过70%，中度肝硬化者切除不超过50%，重度肝硬化者不能作肝叶切除。④术后易复发，应加强综合治疗。⑤如手术探查发现肿瘤不能切除可行肝动脉插管化疗 肝动脉结扎。2．化疗①经股动脉插管在肝动脉内注射明胶海绵堵塞肿瘤供血的血管和化疗药物（阿霉素、顺铂、替加氟），非手术治疗的。②经皮穿刺无水酒精注射（对较小的肝癌可能根治）。主治语录：关于蛋白电泳：白蛋白降低、γ球蛋白增加：肝脏疾病-急性疾病多无异常，慢性肝炎、肝硬化、肝癌时白蛋白减少、γ球蛋白增加；结缔组织病-伴有多克隆γ球蛋白增加；骨髓瘤、原发性巨球蛋白血症-单克隆γ球蛋白明显增加，可见M峰；白蛋白降低、γ球蛋白降低：肾病综合症时高血脂导致α2、β球蛋白增加；蛋白丢失性肠病，只有ALB和γ球蛋白降低；历年真题（执）1．原发性肝癌中常见的首发临床表现是A．恶心、呕吐B．食欲减退C．体重下降D．肝脏肿大E．肝区疼痛（研）2．对原发性肝癌高危人群进行普查的主要方法有A．血清AFP测定B．腹部CT检查C．腹部B超检杳D．肝MRI检查参考答案：1．E 2．AC
显示全部信息

Shipping Overview: 

• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom, Germany and Japan to the United States charges 14.99. 

• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment. 

• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days. 

• International Shipping: Currently, we only ship within the USA. 

• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.

Shipping Delays: 

Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.

Shipping Options:

  • Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.

  • Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.

  • Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.

  • Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.

Delivery Details:

  • Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.

  • Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.

  • Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.

Shipping Confirmation:

You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.

Order Modifications:

If you need to cancel or modify your order, please contact our customer support immediately.

Issues with Delivery:

If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.

Customer Support:

Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.

Return & Refund Policy Overview

Please review our return and refund policies below to ensure a smooth transaction process.

Return Policy

  • Duration: You have 30 days from receiving your item to initiate a return.

  • Condition: Items must be unworn, unwashed, with original tags and packaging intact.

  • Shipping Costs: Customers are responsible for return shipping costs.

  • Packaging: Ensure returned items are well-packaged to avoid damage during transit.

  • Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.

  • Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.

How to Return

  • Method: Returns must be sent back by mail to the address provided in the return instructions.

Return Label

  • Defective Products: Return labels are provided for defective items.

  • Non-Defective Returns: Customers are responsible for obtaining their return shipping label.

Product Conditions for Return

  • Eligible Products: Returns are only accepted for items in new condition.

Nonreturnable Items

Certain items are not eligible for return:

  • Electronic devices after 30 days (e.g., computers, laptops, Kindles)

  • Gift cards, prepaid game cards

  • Perishable goods, live insects, some jewelry, some health and personal care items

  • Customized or personalized products

  • Items with special shipping restrictions

Refund Policy

  • Window: Eligible products may be returned within 30 days of delivery for a refund.

  • Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.

  • Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.

Claims

Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.

Exchange Policy

For the quickest service, return your original item and place a new order for the desired product once your return is accepted.

Return Address

EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366

Customer Support

Available 24/7 for any questions or assistance needed:

  • Phone: +1 636-312-5925

  • Email: cs@everymarket.com

 

产品特色

内容简介

北京协和医学院是中国*早的一所八年制医科大学，在近100多年的办学过程中总结了相当多的教学经验，在很多的科目上有着独特的教学方式。本套丛书是以协和老师上课笔记的整理为基础，根据第九版教材进行精心编写，实用性极强。本套丛书的特点如下：①结合课堂教学，重难点突出。总结核心问题，突出重难点，使读者能够快速抓住内容；精析主治语录，提示考点，减轻读者负担；精选历年真题，力求简单明了，使读者易于理解。②紧贴临床，实用为主。医学的学习，尤其是桥梁学科的学习，主要目的在于为临床工作打下牢固的基础，无论是在病情的诊断、解释上，还是在治疗方法和药物的选择上，都离不开对人体*基本的认识。桥梁学科学好了，在临床才能融会贯通，举一反三。学有所用，学以致用，贴近临床，实用为主。③图表形式，加强记忆。通过图表的对比归类，不但可以加强加快相关知识点的记忆，通过联想来降低记忆的“损失率”，也可以通过表格中的对比来区分相近知识点，避免混淆，帮助大家理清思路，在*程度上帮助我们理解和记忆。

作者简介

主编陈玮，北京协和医学院八年制博士毕业，现就职于中日友好医院。参编人员均为北京协和医学院八年制博士毕业生，现就职于国内各大医学院校或医院。参编多部学术专著的编写工作，发表SCI及在国内核心期刊发表多篇论文。

目　　录
章 支气管扩张核心问题1．支气管扩张的诊断、治疗原则和方法。2．支气管扩张的病因及发病机制和鉴别诊断。内容精要支气管树的异常扩张，多继发于呼吸道感染（麻疹、百日咳后的支气管肺炎）和支气管阻塞，由于支气管及其周围肺组织的炎症破坏支气管壁引起支气管管腔变形、持久扩张。主要表现为慢性咳嗽、咳痰、咯血。一、病因①主要由于支气管-肺反复感染、支气管阻塞；感染导致粘膜水肿、分泌过多而阻塞，阻塞后引流不畅又加重感染。②百日咳、麻疹后的支气管肺炎是常见的原因，多见于左肺下叶；结核纤维组织增生和收缩牵拉，多发于上叶尖后段和下叶背段；ABPA损伤支气管壁；支气管内外肿物、瘢痕狭窄等都能导致远端引流不畅而扩张。③部分患者为特发性支扩。主治语录：病因的遗传因素中有个卡特金纳综合征，有时需要引起重视。二、病理生理支扩部位血流正常、通气减少，造成功能性分流，引起低氧血症；病变广泛破坏肺毛细血管时，由于缺氧导致肺小动脉收缩，肺循环阻力增加，可造成肺动脉高压；三、临床表现1．症状多发于儿童或青年，可有百日咳、麻疹后肺炎或支气管肺炎迁延不愈的病史；以后常有反复的下呼吸道感染。慢性咳嗽、咳痰（变动体位时明显、急性感染时痰多数百毫升、静置可以分泡沫层、黏液层、脓性层、坏死沉淀物，厌氧菌感染有臭味）、反复咯血（有的患者只有咯血，干性支扩）。2．体征下肺和背部比较固定的粗湿罗音、常有杵状指。四、辅助检查①CXR--粗乱的肺纹理中有蜂窝状透亮阴影、沿支气管的卷发状阴影，感染时阴影内出现液平。②CT--HRCT可确诊，管壁增厚的柱状扩张、成串成簇的囊性改变。五、鉴别诊断①慢性支气管炎-中老年吸烟者多见，慢性咳嗽、咳痰（脓痰少，多为黏痰），冬春季节多见。②肺脓肿-高热、咳嗽、大量脓臭痰、CXR可见空洞和液平。③肺结核-结核中毒症状，PPD、痰检、CXR可以鉴别。④先天性肺囊肿-继发感染时可发生咳嗽、咳痰、咯血，X线可见多个边界纤细的圆形或椭圆形阴影，周围无浸润，HRCT可明确诊断。六、治疗1．急性期治疗急性感染时抗生素治疗。2．保持呼吸道引流通畅①体位引流，每次15～30min，每天2～3次，间断深呼吸并用力咳嗽、拍背可以提高效果可先用雾化吸入、祛痰剂稀释痰液。②纤维支气管镜吸痰。③支气管扩张药（不咯血时）利于痰的排出。主治语录：祛痰时注意病人的相应体位，以便顺利祛痰。3．咯血的治疗①咯血时患侧卧位，妊娠和高血压不能使用垂体后叶素（提高血压、促进宫缩）。 ②咯血危及生命、反复咯血病变不超过2叶时可手术切除。4．手术治疗 手术是根治的方法，病变局限于一叶或一侧肺，反复咯血或感染者可手术。历年真题（执）1．双侧支气管扩张反复大咯血，A．抗生素B．支气管动脉栓塞C．切除病变肺叶D．口服钙通道阻滞剂E．支气管镜下介入治疗（研）2．男，43岁。反复咳嗽、咳脓痰10年，加重5天入院。吸烟史15年，已戒10年。查体：右下肺可闻及较多湿啰音及少量哮鸣音。可见杵状指。胸部X线片示右下肺纹理增粗、紊乱。该患者应首先考虑的诊断是A．支气管结核B．支气管肺癌C．慢性阻塞性肺疾病D．支气管扩张E．支气管哮喘参考答案：1．B 2．D第二章 原发性肝癌核心问题1．本病的临床表现和诊断治疗要点。2．本病须与哪些疾病作鉴别。内容精要自肝细胞或肝内胆管细胞发生的癌，表现为纳差、消瘦、乏力、肝硬化表现、肝痛、肝脏肿大。一、发病机制①乙型和丙型肝炎、酒精导致肝硬化常可导致肝癌发生。②血吸虫、淤血、胆汁淤积导致的肝硬化与肝癌无关。③黄曲霉毒素污染的或含有亚硝胺类物质的粮油、食品。二、病理特征1．大体分类①块状型-直径 5cm， 10cm的为巨块；易发生坏死导致肝脏破裂；主治语录：边缘可有小卫星灶。②结节型-直径 5cm；③弥漫型-米粒到黄豆大小的结节弥漫分布全肝，多死于肝功能衰竭；④小肝癌-单个结节直径 3cm或相邻2个结节直径之和 3cm。2．细胞分型①肝细胞肝癌占90%；②胆管细胞癌 10%；③混合型或过渡型。3．转移途径（1）血行转移①首先侵犯门静脉形成癌栓，导致腹水并在肝内形成多发转移；②下一站转移到肺；③肿瘤血供主要来自肝动脉。（2）淋巴转移-多见肝门淋巴结。（3）种植转移-癌细胞脱落种植到腹膜、胸膜（形成腹水、腹水）。三、临床表现早期可无任何症状为亚临床型肝癌，晚期可有肝硬化、肝大、肝区疼痛、黄疸的表现。1．全身表现发热、消瘦、纳差、乏力、营养不良。肝是维持糖代谢的重要器官-肝病时会发生自发性低血糖。主治语录：注意与内分泌瘤鉴别。2．肝硬化表现肝功能减退、脾大、腹水、侧支循环；血性腹水较特异。可能由于肝癌本身伴有肝硬化，也可由于癌栓堵塞门静脉主干。3．肝区疼痛持续性钝痛-肝癌增长导致包膜牵拉，侵犯右膈时右肩牵涉痛。癌结节破裂-血液和坏死组织进入腹腔，突然剧痛，遍及全腹，可引起休克。4．肝大质地坚硬、凹凸不平、压痛、血管杂音特异（动静脉瘘）。四、并发症（1）肝硬化的并发症①肝性脑病②感染③上消化道出血④肝肾综合征；（2）癌结节破裂①局限在包膜下可产生压痛性肿块②包膜破裂发生急性腹痛和腹膜刺激征、出血、休克③补液、输血、止痛、紧急肝动脉栓塞；五、辅助检查1．血液检查（1）AFP升高①除外妊娠和卵巢生殖细胞肿瘤（内胚窦瘤）的基础上对肝癌诊断有意义②也可见于肝炎、肝硬化、转移癌（升高幅度不高，与ALT平行）③ 500ugL持续4w、 200ugL持续8w、浓度逐渐升高不降④可早于症状8～11月；主治语录：AFP升高但 200ugL，与ALT同步变化提示慢性活动性肝炎、肝硬化2．影像学检查（1）CXR-右膈高位提示肝癌。（2）BUS-可发现直径 2cm的肿瘤，BUS AFP=普查。（3）CT-局灶性边界清晰的密度减低区，可发现直径 2cm的肿瘤，同时进行肝动脉造影CTA可发现 1cm的肿瘤，增强时造影剂快进快出。（4）DSA血管造影①选择性腹腔动脉和肝动脉造影可发现 1cm的肿瘤。②CT、Bus不行才选用，发现小肝癌的。（5）放射性核素-99mTc-HIDA、99mTc-PMT可以被肝细胞摄取然后分泌进入胆道系统，肿瘤细胞摄取后不能分泌进入胆汁，所以可以使肿瘤显像，多排除血管瘤。（6）肝穿-可以确诊。六、诊断对肝炎史 5年或乙丙肝阳性，年龄 35岁患者；每年1～2次BUS AFP。七、鉴别诊断①非癌性占位-肝脓肿（肝大无结节、触痛明显、右上腹肌紧张、血象高、BUS可见液性暗区）、血管瘤、包虫（可通过CT诊断）。②转移癌-AFP阴性，关键是找出原发灶和病理检查。③活动性肝炎-ALP和AFP往往同时升高，其他肝癌标记物阴性。④肝硬化。八、治疗1．手术切除①一般状况好无心肺肾功能损害、肝功能I级（无明显腹水、黄疸、远处转移）、病变位于一叶或半肝、未侵犯肝门和门静脉。②不能手术的肝癌综合治疗后缩小或术后复发较局限者也可手术。③肝功能正常者手术切除不超过70%，中度肝硬化者切除不超过50%，重度肝硬化者不能作肝叶切除。④术后易复发，应加强综合治疗。⑤如手术探查发现肿瘤不能切除可行肝动脉插管化疗 肝动脉结扎。2．化疗①经股动脉插管在肝动脉内注射明胶海绵堵塞肿瘤供血的血管和化疗药物（阿霉素、顺铂、替加氟），非手术治疗的。②经皮穿刺无水酒精注射（对较小的肝癌可能根治）。主治语录：关于蛋白电泳：白蛋白降低、γ球蛋白增加：肝脏疾病-急性疾病多无异常，慢性肝炎、肝硬化、肝癌时白蛋白减少、γ球蛋白增加；结缔组织病-伴有多克隆γ球蛋白增加；骨髓瘤、原发性巨球蛋白血症-单克隆γ球蛋白明显增加，可见M峰；白蛋白降低、γ球蛋白降低：肾病综合症时高血脂导致α2、β球蛋白增加；蛋白丢失性肠病，只有ALB和γ球蛋白降低；历年真题（执）1．原发性肝癌中常见的首发临床表现是A．恶心、呕吐B．食欲减退C．体重下降D．肝脏肿大E．肝区疼痛（研）2．对原发性肝癌高危人群进行普查的主要方法有A．血清AFP测定B．腹部CT检查C．腹部B超检杳D．肝MRI检查参考答案：1．E 2．AC
显示全部信息

Shipping Overview: 

• Shipping: Standard Domestic Shipping within the United States charges USD 4.99. Standard International Shipping from United Kingdom, Germany and Japan to the United States charges 14.99. 

• Order Processing: Please allow 1-2 business days for order processing and preparation before shipment. 

• Domestic Shipping: Orders within the U.S. are shipped via USPS or FedEx, depending on the origin of the product. The average transit time is 3-7 business days. 

• International Shipping: Currently, we only ship within the USA. 

• Tracking Information: Every order is trackable. You will receive a tracking number once your order has been shipped. Products may be shipped from various global fulfillment centers.

Shipping Delays: 

Please note that shipping times may vary due to factors beyond our control, such as weather conditions, natural disasters, or peak holiday periods. While we strive to ensure timely delivery, the exact arrival time cannot be guaranteed and is managed by the shipping carrier.

Shipping Options:

  • Standard Delivery: Most orders are shipped within 3-7 business days. Larger items may utilize LTL shipping for safe handling.

  • Handling Time: We handle shipments on business days (Monday - Friday), with a preparation time of 1-2 days.

  • Additional Charges: Some items require additional shipping charges due to their size, weight, or special handling. These charges are specified on the product pages and are not eligible for shipping discounts.

  • Exclusions: Gift cards, packaging, taxes, and prior purchases do not count toward the minimum purchase requirement for free shipping. This offer is valid only for shipments to U.S. addresses, including Puerto Rico.

Delivery Details:

  • Estimates: Standard shipping within the US typically takes 3-7 business days. These are estimates and not guarantees.

  • Shipping Restrictions: We ship to all 50 states, Washington, DC, U.S. territories, and APO/FPO/DPO addresses. Shipping options vary based on the delivery address.

  • Remote Areas: Shipments to remote areas may incur additional charges or require pickup from a nearby shipping partner’s location.

Shipping Confirmation:

You will receive a shipping confirmation email with a tracking number as soon as your order is dispatched. If you do not receive this email immediately, please be assured that your items will arrive within the estimated delivery window provided at checkout.

Order Modifications:

If you need to cancel or modify your order, please contact our customer support immediately.

Issues with Delivery:

If your order shows as delivered but you have not received it, please contact the shipping carrier directly to resolve the issue. For persistent problems, contact our customer service at cs@everymarket.com.

Customer Support:

Our team is available 24/7 to assist you with any questions or concerns regarding your order. We are committed to ensuring a smooth shopping experience.

Return & Refund Policy Overview

Please review our return and refund policies below to ensure a smooth transaction process.

Return Policy

  • Duration: You have 30 days from receiving your item to initiate a return.

  • Condition: Items must be unworn, unwashed, with original tags and packaging intact.

  • Shipping Costs: Customers are responsible for return shipping costs.

  • Packaging: Ensure returned items are well-packaged to avoid damage during transit.

  • Tracking: Use a trackable and insured shipping method as we are not liable for items lost or damaged on return.

  • Initiating a Return: Contact us at cs@everymarket.com to start your return. We will provide a return shipping label and instructions upon approval. Returns without prior approval will not be accepted.

How to Return

  • Method: Returns must be sent back by mail to the address provided in the return instructions.

Return Label

  • Defective Products: Return labels are provided for defective items.

  • Non-Defective Returns: Customers are responsible for obtaining their return shipping label.

Product Conditions for Return

  • Eligible Products: Returns are only accepted for items in new condition.

Nonreturnable Items

Certain items are not eligible for return:

  • Electronic devices after 30 days (e.g., computers, laptops, Kindles)

  • Gift cards, prepaid game cards

  • Perishable goods, live insects, some jewelry, some health and personal care items

  • Customized or personalized products

  • Items with special shipping restrictions

Refund Policy

  • Window: Eligible products may be returned within 30 days of delivery for a refund.

  • Refund Method: Refunds are processed to the original payment method or as store credit for items purchased with gift cards.

  • Processing Time: Refunds are processed within 3-5 business days after we receive the return; please allow additional time for shipping and bank processing.

Claims

Inspect your order upon arrival and report any defects, damages, or incorrect items immediately to allow us to address the issue. For claims, contact our support team with details of the issue.

Exchange Policy

For the quickest service, return your original item and place a new order for the desired product once your return is accepted.

Return Address

EveryMarket Customer Service 2101 E Terra Ln, O'Fallon, MO 63366

Customer Support

Available 24/7 for any questions or assistance needed:

  • Phone: +1 636-312-5925

  • Email: cs@everymarket.com

 

Oops!

Sorry, it looks like some products are not available in selected quantity.

OK